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目的：探讨心室晚电位识别心肌梗死高危病人的预测价值。方法：用体表信号平均心电图的时城分析法，动态观察141例急性心肌梗死患者心室晚电位的演变并做1年随访研究（分为猝死组与无猝死组），分析比较不同时间记录的心室晚电位阳性率及其参数，分析随访期心室晚电位的预测价值。结果：心肌梗死急性期有85。6%病人保持前一次心室晚电位明性或阳性的结果不变，前后二次各项参数的均值差异无显著性（P＞0．05）并呈高度相关（γ=0．68～0．91，P＜0．01）；随访期相当一部分病人的心室晚电位自然消失，猝死组与无猝死组的晚电位阳性率有显著差异（P＜0．05），晚电位预测猝死的敏感性、特异性、准确性、阳性和阴性预测值分别为77．8％、68．1％、68．8％、16．3％和97．5％。结论：心肌梗死急性期的心室晚电位检测具有很高的重复性；无论是心肌梗死急性期还是随访期的晚电位对识别心肌梗死高危病人均有重要价值。
Objective: To investigate the predictive value of ventricular late potentials in identifying high-risk patients with myocardial infarction. Methods: The City ECG analysis of body surface signal average method, dynamic observation of 141 cases of acute myocardial infarction ventricular late potential evolution and do 1 year follow-up study (divided into sudden death group and no sudden death group), analysis of different time records Ventricular late potential positive rate and its parameters, analysis of the predictive value of ventricular late potential during follow-up. Results: 85.6% of the patients with acute myocardial infarction had no significant difference in mean or positive values of the previous ventricular late potentials (P> 0.05), and were highly correlated (Γ = 0.68-0.91, P <0.01). The ventricular late potentials disappeared in a considerable part of the patients during the follow-up period, and the positive rates of late potentials in sudden death group and non-sudden death group were significantly different (P <0.05 ). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of late potentials predicting sudden death were 77.8%, 68.1%, 68.8%, 16.3% and 97.5% respectively. Conclusion: The detection of ventricular late potentials in the acute phase of myocardial infarction has high repeatability. Both the acute phase and the late phase of myocardial infarction have important value in identifying high-risk patients with myocardial infarction.